ABS_GA_61-852_02_99F.pdf

RAVENNA, ARMY MotlliNITIOO PIAN!'

Balj 1dirq SuIIInary Sheet

Farm A

Building ID:

Building Type (Use):

NLm1ber of People/ Percentage of Time:

Area:

Inspection Team (Names): 1!kk.<L Cmh{ OJ. CChclD l Drawing Numbers: 1500 -1...\

Year of Construction:

----;T Transite Siding

Total Square Footage Building: rSbttM. \Mr{f----....L.L..,US""L-l.;:tOC..L.l4,L-) _

Floors: 1

Basements/crawl Spaces:

Fan/Boiler ':R6oms:

samples Taken:

Q.A. samples Taken: o Type of CCnst:ructicn:

(Cleek Applicable)

~ Wood Frame J steel Frame Masonry Reinforced Concrete

Comments: ~ COr() fb,S1 17 () tJ r2S '200 FT 2 ) I

Portion of Building Not Inspected (square feet):

Reason:

RAVENNA A:IMl ~rn PIl\NI'

BUIID:rnG SlMJJARY SHEEr

FOR1 B

Buildirq #: J2l- ~ )"2 Sheet No. ' of ~ ~----sample # 0 Drawirq # Revision # OCCUpied Floor # Material Encapsulated Friable Condition Quantity A Room # - or 1-5*

Area Type Descr:~ption/ Enclosed (l-Best A.rrount Unit Pipe lDcation 5-Worst Dia

DO \ ~ lSOO' 2\ No We7\ ~r'\

.:Gl?~o.e.

AcM h-ofv1 ~eJ ~\r'()J'" ~ c\l-t\ 2 No 2 NG1 I i

ACM

~O2 fJ I' 'I II MuJdiAC . 1 I ~ VJ!.S 3 ') r

~t2

I ' , I

I

00> tJ l \ I( w~ ~ ~ lli~u\Q... (,.)~ t:.i'~b\ cb.d>

M-uM\~\~\Qr 2 No ~ 2) rl(l, F-t {s II A-CM (Sc\J" (L

\0J.i( 1'-')

004 ~ \ I \ \ f"o.*

IA'l~~t\e

~b~~ ~\-~ h,e.

Vl°"\\ G" f,J,6mJ pC>..~\ ~ ~l\e.- I vUe 3 IEBto4 ~l-z. , tJDs \-l \ I 'I ~tt\f\s\+e ~+- ~~.~

~c;~ ~(.l~J,~ ~~% 0 r0D ~ 8?ic4 toe ~CM

~(;)b iN ", II e~\:'~~e..

br \=''C€..

(...)0' \

ImH ,,. ~Nwrn~{$

~t- <;~e. c9s;:"

_YCAl'\

() Nv ~ N(Q ACM1 I

COrmnents:

1- ! : 47(6 I ~ f1i __ __ _ ~5i 'Ie.c- PO-WI\- 6ul> l-dc/ f{J551Ma '6~~b~fo-s ~'Alduv~

_ ___ -fuL b~\\ cl~ ~ pu ~~~ -t-e-r. .

_____ ____~ __B_J _:f(O.ll.5_L+e bocu-cL_cx_ro wJ _60-£' IdL~~-- fen~e kc, _

~ 1M to-1K ~1h Ojl--\&Qhh> (ttl\Lls .

_~_E~ IOJe...r\6'C_5·\&\h~ w I-kts- U)'Jf?rL~~' IS )l-\5pe-d-. _ ) :;OfY\!- 5<A)~+-- (£LulkM~ +h i'~~b 6~t bl-<.i }Jif\~. __ - --- - - ~(ral\.s,t-t€- J..e!Jr(S DcA~IC\e.. f)/l f)te?L.iflct ~llatClCvld

; he M Roe>f M r\S G\ l1 oJD lLv1J .

62---C;3I '. ~ as ahc~ bCAf-;

~ ~ ~c t M cuLt~ CL 0" ckk IJ-n ;01(+: t~ ~ f' _ ~ vJ.e s.-\- Q <9"'-=

!;bMi PrC h ~edcet- 6/\ Oflltl U/'\J \S-u? \" ~

,Jw- (,Jfltf u/~; (0~ r?CLl~ t-ei' e.tk( l~r JL(cF- 06rt- 2)4~Ft! J54~

Q2---~)1 5QMQ q~ 61- --~» bJ- ~)i ~ CA~ ~b00~

JJ 'jrg)O - bu'\ \l.A-"o :" CJl(c<p«lct+J wi <1. 5frD..-,(hM MU'l

5 V\.5pec+- k>CVVl ex.. ce.frr ~ ~er- h~s J- e-t r/fQ.v1. ~.

- Y'\O lA<)~Q- ku-.

- f\0 tJ«lbeb&-c1; _Q~l~ C2- _

b) -- t3£ - ~.ClML 4.5> b1. -?J:5 5-- - - ------ -- -- -- --

.., t\o() ~< t) ~ "i'1'.lr ~ 0 o..o..~ ~

6 l - S'1l- Sq~ ct.s ~6(J Vf<

- ~\:) ~f' () ~ " '" ,,4r ~ 6 ,~~ b{- g;z '. as$ttMt otkr?

-:fl() chJ [n)lO'e {a.~ ~G6a~ ff\)~&e.- --no W klt- ()V\ N+~ (i) c\t)G,t;-> 6!J--?J37 f,~{AMJ- ~~ Q~S

-= 1(\0 he- 1V\ ~:d\P la'p-r 0 \ b~ (As.l~~e

I ~P~

~~ ~\\M bq- g[~,S~rv'\L D-h Dtkrs-.

-% ~ \l\S~ <L l~y ~ boos-A 1-~~l'&e..-

~(Vl9~

6~-~) ~ : Sc.~MQ.. C\}~ o~~

26 &~' d- ~ ~~N\S ~ ~~ t-rtY\ y-~4]~M~ w~~~r-- ~~ furf\u-lQ ~ u~-J 4-q' 14(3

P A-l (c:; (7 R~114(Z

~ (\0 1-0., lJ');~~ lo.~ O~ b<§w-o\ b2-q:;~/~ >().fV/.R- p.g. (jJt(.tJ7

-= r1f9 WLikvtliJ ~(er

G3-9jq ,>(l,~ Cts c9!/w-s r-(U) W ~» f\Qr l'ty-0' vJ/ 06a..~ f/lf) Muvv\,f~d t\~ J ~~ ~~ vvl, lOJS,f.- f'yCiV\ qLLsr..e-f vJ!50M9- AiLLJJ{~~ .Le~ &--~ ~ 'IS

6~Jb)~ ~ ~~ CAS (j~ ~ 'l- CO'~oJ--W-. lore1 flf) ill i)Ar --(zv ~

,0 '4 -Cf:>Iq~ ", Su~ e>vj () ~rwrj

~ \) leY\{J.>~ ~ (se;'~ w I ~ \f) '7 cbr I

RAVENNA l\Rt!Y M-MHrI'IClf P.[M{r

.lISBES'IDS BUlK S2\MPLE rnAIN-QF-aJSIOOY REmRD ~E

Laboratory Name: ~ I YllTSE:vQGf-I Control Number:

Date samples Collected: ~ Date Received in lab: q-II-Cfj sampler's Name: MICHA-fU., T. 61<08 Name:

sampler's Signature: fk'kISlue2 r=):L\O'lsignature:

sample Field sample laboratory Identification No: bUI LO J}J~ -#= ~ i-852 Identification No:

~ l-b52~CXJ l /BeB c.;5

I' II - 00"2- /8 C), l/C:, II ~OO3 /8 c1 LI 7

\( q -004- 18dLf8 II I{ -C0S- 18d-Lj1 V\ 'I

~CO~ 18 ;)50

DiS}X)Sition: __X__ samples Disposed of

____ Delivered to CMner or Agent

Receiver's

Signature: Date Received:

Laboratory Name: fS 1 Pl1T5WR6 H 8U\LD\N,6 ~ ~1-8sc ID Num1:er: -#: (9 1.:: EL c;z. -co I

Lab Num1:er: q 0 qhi 7 \'B l:rs ID Technique: eLM DIS~S:J()N '::'TB\N INA

Gross sample I::escription: ln~4 U\1..v?! -t.L;;,~=-=-=''---,---\ -=(,~,---' _ lvf..at:erials Present: bf6ll.E:::\ ~AL

*Estimated~cent in <:;:;>mnle: 'I)- - ~ofi.

AsCestos:

Qrrysotile

Ve;

'-"'-"'t"' ----~------------

-!-) -5 D

Arnosite croc:idolite

Anthophlyllite I

Tra~lite/Actinolite

Non-AsbP..stos Fil:ers: \Ie~

Glass Fil:ers

Mineral Wool I cellulose 'f~ -:>"U

Synthetic Fil::ers other

Non-Fibrous Component

*Percentage is Visually Estimated Analysts Comments ~.Lol-

Date: 1~/;3/9/

Laroratory Narre: Ps 1 p\rr5EUR~ H BulLD\N6 4t- <'o\-~57.

ID NurrU:er: *' (0) - ~52.- - 06:

lab NurrU:er: 9- 0 CJ..~ 7 7 1'8 ~9....:;.G?_-..,...

ID Technique: eLM D!St=t.e--SJDN .5TBIN fNt;

Gross sample Ces=iption: _~~I >~""'I ~f-/ _

~.aterials Present: i'VG...=:..:::::I.-_..JI.ICv1...!...J,...::lJD~D.,L.l...1.( _

*Estimated Percent in Sa!l1ple: --+:Or-------------- ?¥ Asrestos: rJ .)

Qrrysotile I Arnosite I crocidolite I Anthophlyllite

Tremolite/Actinolite/

Non-.lS~ testes FiJ::ers:

- , V(-7 ~

Glass Fibers , f)~tJ

Mineral Wool cellulose 3'5 I Synthetic Fibers I other

Non-Fibrous Component ;\f, Pr

*Perce.ntage is Visually Estimated Analysts camments

Date:

IabJratory Name: PS 1 plrr.sWR6 H8U\LD\N6 #=- ~ 1-852 ID Nurnter: -#:' Cz.[ - 552. - Q:?2, lab Nurnter: goCfb77 \'6'J\L{l ID Technique: PLIY\ DlS~SJDN STBIN INti .

Gross 5arrple cescription: l~(w, fL~~ \~/~ Materials Present: TA1L aUGI LLXU\P

*Estimate::l rerce.'1t in 5arrple: _....:....l----=~'-- _

*"Asrestos : y~

Orrysotile \-") (1M ~~ ~) Arnosite

Cr"ocidolite

Ant..'lophJ.yllite I TremolitejActinolite

Non-Ast:es+.-es F:iJ:er:::

Glass Fibers cellulcse tlfJ -q-{

Synt..'letic Fibers other

Non-Fibrous Cornp:>nent Ai A·

*Percentage is Visually Estimated Analysts Comments

Date: 11123/7'/

~~A4W

LaJ::oratory Narre: PS \ PlrrSWR6 H 8U\LD\N6 #=- (0)-85'2 ID Numl:;er: *' Ca\ - P::L--0 04:

lab Numl:;er: :1 0 !lh. 7 7 \~&-i6'

ID Technique: PLIY\ DJS~()N .5TBIN tNt1

Gross Sample Description: lC)A,\ttj.d, awl") 11~ 61.lo"!\ 1'1:1;.;6I

4 \ i I

Materials Present: GA:LPh.s-mS CGA-I7NG ..,Ii

*EstiJrated. Percent in S2mPle: __0 _

A('Ast:estos: !'1'V

Qu:ysotile

Amosite I Crocidolite I Ant...'1ophlyllite

Tre."llOlitejActinolite

Non-Asl:estcs Fibers:

y Glass FiJ:ers I Mineral t-lool cellulose Lj

Synthetic Fibers other

Non-Fibrous Comp::ment

*Percentage is Visually Estimated Analysts Comments

I.al:xJratory Name:

ID Nurnl:er:

lab Nurnl:er:

ID Tedmique: eLM DlSS?££.-SJDN 'sTBIN INt;

Gross sample Description: '~¥'lCAV' \~~\<- i $~ Materials Present: T72Jri\lSIT/z.. £o~

*Estimated Fercen¢sample: _ )~~_,5..L.---''::'''\'.i_~ _..... ~*Ast:estos : Ye ( Olrysotile 1 'd-S-;c Arnosite I erccidolite I Ant.~ophlyllit2 I Tre~lite/ActinOlitel

Nor.-As.t:estos FiJ:ers: N \)_

Glass FiJ:::ers I Mineral t.)'<XlI I cellulose I Synthetic Fibers I other -/

Non-Fibrous Cornp:Jnent

*Pe.rcentage is Visually Estimated

I.ab:>ratory Name: fS' PIITSBOR6 H8U\LD\ N6 *- 0 \- 65z ID Numl:er: -tt- (0 \- t>? 2 -COCO

Lab Numl:er: q0 C( b 1 7 ID Technique: PLIY\ DlSt?Ee--SJDN STAIN INt;

GroSs sample I:escriptian: _!Ys«v'~-l'""'1 ~di0-, ~,,,...,;.el+------- Materials Present: C A-v L.¥-.(N~-:------'--'------''--------------- *EstiIrated perce..'1t~sample: ---1..\\:>~---=.:\~~ _

;¥Asrestos: ~ f' ,f~

Qrrysotile \O~ \S Arnosite crocido1ite

Anthophlyllite

Tremolite/Actinolite/

Non-Asbestos Fibers:

Glass Fil:ers I cellulose

Synthetic Fibers other

Non-Fibrous Comp:Jnent

*Percentage is Visually Fstimated i

~lIME"

01\11'.'.

OG !>lO.

6L WING !>lO' . \. • ,._ _ . ~_ ~.•t<.,..... .., .';"~~:;:, ::~:;~;~.. . .'.}~ ~:"-=i'Jij~~2!\!1~'f' . .• 1\1\[1' ,.,1'1'. . ,"" ~ ~ ."\:_ - '.f :... ~N\J\"f..I\\I\L . ~" •• ~", ;:.,"

~ ••J' - --,~o---=-~l~, \c.:;txN\i"lEO B"f· ~ ___

Ie iIit· t -",. P... . -sr Building No: Floor No: __, _

Drawing No: Room No: r~I\S\~

Date: Evaluator: rY\Tg__---'-=..L__

On:rellt o:nliticn of AaM

Present Absent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

Potential for Future Di.st:urbaIx;e

Damage or EI:'osicn of AaM

Proximity of Air Plenum or Direct Air stream

Visibility, Accessibility (to

Wilding occupants am maintenance personnel), am degree of activity x (air movements, vibration, movement of Wilding occupants)

Olange in Building Use

Occuparq

OCCUpied Unoccupied

ICUrrent Occupancy I

RAVENNA AIM{ AMUUTICfi PIANr RISKk~~

FOlM C

Build.irg No: 0'Z~5Z- Floor No: ~ Drawing No: /S-OO.c f Room No: tU-l1iRJcR

Date: ~I-ro191 Evaluator: YYlSh, Current CCnliticn of A(D{

Present Al:sent

Evidence of deterioration of delamination from underlying surface X

Evidence of Physical Damage ~

Evidence of Water Damage y

I

RJt:ential far Future ni.sturl:larre Doonage ar Erosicn of A(D{

Proximity of Air Plenum or Direct Air stream X

Visibility, Accessibility (to Wild.irg occupants am maintenance personnel), am degree of activity (air movements, vibration, movement of Wilding occupants) X

Cllange in Building Use X-l

OCCUpied Unoccupied

IQrrrent OCCUpancy I I------'--~_

J~~OV\~

Building No: {02- caS'2- Floor No:

Drawing No: 1500.<..-/ Room No:

~Izol~~l-- Date:

Evaluator: ----=----=--=1---

OIn:ent CCntiticn of ~

Present Al:sent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

Potential far Fublr:e oi.stm:i:lan:e T\3mage ar Er:'Osicn of ~

Proximity of Air Plem.nn or Direct Air stream

Visibility, Accessibility (to

Wilding occupants arrl maintenance personnel), arrl degree of activity

,(air IOClvements, vibration, movement of Wilding occupants)

C1'large in Building Use

OCCUpied Unoc:cupied

ICUrrent Occupancy I

DATE:' mEl TI~E:'~

•.....III......iii_-i..- BLDG. NO.:DRAWING NO.:

BULK SAMPLE NO.:.'?::;

AREA SAMPLED: .'

.11."IiI••'~~~ MATERIAL TYPE:- -".• CAHLS 131 11'JSAMPLED BY: MICltA(L T GAOH .'I":!~II!~~'~~~~"'!!IIJIIIl ••i

A'.-, ,